The months leading up to the presidential election and the aftermath have revealed some serious problems in our country as well as present dangers. In order to not get sucked in to the vortex of fear and loathing that is getting flamed by incendiary individuals hollering from their pulpits, ongoing racial tensions, and an increase in heightened bigotry and hate crimes, we need a tap code. A way to communicate effectively with others about what we need. And a support system with which to receive shelter and solace and engage in strategy for moving forward.

Decades of research have shown that social support is good for most people’s physical and psychological health. And, as a clinical psychologist, I say it’s even more important now.

When I’m feeling down or need a point of inspiration, I look around at people who have endured enormous stress and trauma, and see what strategies they use.

For years, I worked clinically with U.S. former prisoners of war (POW). The POW experience is one of the most horrific, degrading, and life-threatening cruelties known to humankind. These individuals are exposed to intimidation, interrogation, beatings, death threats, nutritional deprivation, physical torture, and brainwashing. Many live for years in solitary confinement in dark, filthy, rat-infested cells. As a result, they experience tremendous physical and psychological illnesses — from suicidal ideation and post-traumatic stress disorder to gastrointestinal and musculoskeletal disorders. Captivity often breaks people beyond recognition to themselves and others.

One of the ways that U.S. soldiers survived the horrors of captivity in North Vietnam was to connect and communicate with fellow countrymen behind thick prison walls. Based on a grid of five rows and five columns of letters of the alphabet, prisoners could send messages on a letter-by-letter basis by knocking on the metal bars, pipes, or the walls inside a cell and listening for a response by placing their ear on the wall.

With the smell of urine and feces permeating the air, this 25-square matrix, similar to Morse code, allowed prisoners to empathize and reassure one another. They shared questions the interrogators were asking as well as their responses. This communication tool kept their sanity and maximized their survival.

There’s an avalanche of research showing that perceived and received social support, both before and after a traumatic event, are key in determining if someone develops and maintains subsequent mental health problems. Across many studies examining risk factors for emotional distress—looking at things like gender, age at time of trauma, race, education, family psychiatric history, childhood adversity—the variable that packs the most significant punch is lack of social support.

Turning into the national and world events lately, it seems we’re missing that support. Rather than giving one another assistance and working together, many of us are feeling we don’t get enough ourselves and we’re conserving our energy, staying inside and hunkering down for the next attack.

Evaluation of one’s social networks is a needed first step to getting the help one needs. Social support comes in all shapes and sizes. Do you have someone who gives you emotional support, who nurtures, loves, and cares for you? Do you have tangible support, someone you can turn to if you need a ride to the doctors or someone to help you with money if you can’t pay the rent one month or who can provide you a temporary place to stay? Do you have informational support, someone who could give you sound advice, guidance, or assistance in problem-solving? Do you have companionship, feel like there are people with whom you belong, know that you are not alone?

If your relationships are sparse, unhelpful, negative, or conflictual, it’s a great time to increase the size and strength of your network. We all need a sense of common cause and community. We need to rally around one another in a huge healing and protective source. We need to tell others that we care about their welfare and will support them if they fall.

If the hospitalized veterans with PTSD that I currently have the privilege to work with can reach out and engage positively in the world, if they can access a tap code, so can you and I. This is not just a lifeline during these difficult times. Social support is foundational to resilience and forms the backbone or life preserver to resistance from hate.

Originally published at


  • Joan Cook

    Clinical Psychologist, Associate Professor at Yale, Wife, Mother, Advocatefor Trauma Survivors

    Dr. Joan Cook is an Associate Professor in the Yale School of Medicine, Department of Psychiatry. She has over 100 publications in the areas of traumatic stress, geriatric mental health and implementation science fields. Dr. Cook has worked clinically with a range of trauma survivors, including combat veterans and former prisoners of war, men and women who have been physically and sexually assaulted in childhood and adulthood, and survivors of the 2001 terrorist attack on the former World Trade Center.  She has served as the principal investigator on four grants from the National Institute of Mental Health, as well as one grant from the Agency for Healthcare Research and Quality and two from the Patient-Centered Outcomes Research Institute. She was a member of the American Psychological Association (APA) Guideline Development Panel for PTSD and the 2016 President of APA’s Division of Trauma Psychology.